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Help with bloodwork

hollaatyaboyy1

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Trying to get things in order.....

Been on trt for a while now last round of bloodwork my

rbc -5.96
Hematocrit -50.5
Hemoglobin -17.8
Ferritin -38

all high this was on 12/18/20


this is something I’ve struggled with for years and cycling after my last round of bloodwork and the high numbers i donated blood


I decided to see a hematologist and she ran another round of blood work last Thursday the numbers came back

rbc -5.86
Hemoglobin-17.3
Hematocrit- 50.4
Ferritin 20

so the donation did nothing really and what is worrying me is she tested for
ERYTHROPOIETIN and it was high at 20.4

i don’t know anything about this value and its worrying me. Is it because of the trt ? Anyone deal with this ? I plan on doing the phlebotomy ASAP doctors visit in a few days.

thanks
 

danieltx

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High hematocrit when other markers are in range is unlikely to cause problems. What's your platelet count and the range?

Many guys think hematocrit has to stay low for no good reason. They donate blood to get it down, but over time see a rebound - this leads them to donate again, then it rebounds again, etc.

Elevated EPO makes sense, that's what produces red blood cells. Do you have sleep apnea?

I wouldn't donate blood again until you review these numbers with your doctor and get her opinion.
 

hollaatyaboyy1

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High hematocrit when other markers are in range is unlikely to cause problems. What's your platelet count and the range?

Many guys think hematocrit has to stay low for no good reason. They donate blood to get it down, but over time see a rebound - this leads them to donate again, then it rebounds again, etc.

Elevated EPO makes sense, that's what produces red blood cells. Do you have sleep apnea?

I wouldn't donate blood again until you review these numbers with you doctor and get her opinion.
She knows nothing about testosterone admittedly...... pretty much everything else is in range besides cholesterol that I’m working on She told me to lower the dose which I did. And when the results comes back we can do the phlebotomy “if I want to “ I think she assumed that my numbers would go back down with the donation that did before I saw her.
I do have slight apnea I haven’t been wearing my mask stupidly. But I will start again.

platelet count is 216
 

danieltx

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If your platelets are in range then your hematocrit shouldn't be a problem. Quit donating in hopes of getting it to a certain number, there's no reason. Beyond that, hematocrit may have actually gone down between tests, but if you did the second one dehydrated it wouldn't show up as significantly.

Again, do you have sleep apnea? That can cause elevated hematocrit and I suspect elevated EPO.
 

hollaatyaboyy1

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If your platelets are in range then your hematocrit shouldn't be a problem. Quit donating in hopes of getting it to a certain number, there's no reason. Beyond that, hematocrit may have actually gone down between tests, but if you did the second one dehydrated it wouldn't show up as significantly.

Again, do you have sleep apnea? That can cause elevated hematocrit and I suspect elevated EPO.

Yes I edited my original post several times. I have slight apnea I’ll start using my mask again
 

Stewie

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If you have theses, what's your albumin, BUN, glucose, potassium and sodium levels?

You're treading towards tapping out your ferritin levels if you phlebotomize again.

I'd start implementing ferrous sulfate or similar EOD to start regaining your Fe (iron) status. Chances are, you're beating your copper levels down as well.

If you're like the rest of the population under the current situation taking in copious amounts of zinc (Zn) prophylactically to help wort off thee virus that lurks amongst us. I'd suggest cutting back on supplemental Zn until you get this current situation at hand addressed if you continue to unnecessarily phlebotomize.

In some cases where there's not enough Fe to be sufficiently synthesized into hemoglobin (red blood cells) and there's abundant Zn in circulation, this can lead to ZPP (zinc protoporphyrin). This subsequently leads to faulty hemoglobin molecules (deoxyhemoglobin and carboxyhemoglobin-reduced tissue oxygenation) as the incorporation of Zn in red blood cells cannot bind to oxygen, nor transfer it appropriately. The longer you're iron deficient, the more this will stimulate erythropoietin, further producing erythropoiesis (red blood cells) by-way of hypoxia inducible factors (your uncontrolled sleep apnea and iron deficiency-WITHOUT-anemia are the primary drivers) therefore continue to see erythrocytosis in the presence of iron deficiency.
 

Stewie

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If you have theses, what's your albumin, BUN, glucose, potassium and sodium levels?

You're treading towards tapping out your ferritin levels if you phlebotomize again.

I'd start implementing ferrous sulfate or similar EOD to start regaining your Fe (iron) status. Chances are, you're beating your copper levels down as well.

If you're like the rest of the population under the current situation taking in copious amounts of zinc (Zn) prophylactically to help ward off thee virus that lurks amongst us. I'd suggest cutting back on supplemental Zn until you get this current situation at hand addressed if you continue to unnecessarily phlebotomize. In some cases where there's not enough Fe to be sufficiently synthesized into hemoglobin (red blood cells) and there's abundant Zn in circulation, this can lead to ZPP (zinc protoporphyrin). This subsequently leads to faulty hemoglobin molecules (deoxyhemoglobin and carboxyhemoglobin-reduced tissue oxygenation) as the incorporation of Zn in red blood cells cannot bind to oxygen, nor transfer it appropriately. The longer you're iron deficient, the more this will stimulate erythropoietin, further producing erythropoiesis (red blood cells) by-way of hypoxia inducible factors (your uncontrolled sleep apnea and iron deficiency-WITHOUT-anemia are the primary drivers) therefore continue to see erythrocytosis in the presence of iron deficiency.

Edit:
Typo- in bold.


Not quite sure why there's "underlined" throughout?!
 

hollaatyaboyy1

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Edit:
Typo- in bold.


Not quite sure why there's "underlined throughout?!
Thank you. All other levels. Bun glucose and actual iron levels are within range. I was taking a bunch of zinc for a while because of the virus but I stopped 2-3 weeks ago. I was taking 100mg a day. I have the doctors apt weds. And I told her about my worries about my ferritin and she said as log. As you are t feeling light headed don’t worry about the ferritin. But o wasn’t comfortable with that answer either
 

Stewie

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With those labs, Bun, glucose, sodium and potassium will determine how "hydrated" you were. They all can be "in range" it's the configuration of those values can determine if you're sufficiently hydrated.

If your albumin if heading towards 5 g/dL this is suggestive of insufficient hydration. 5 g/dL is "in range" although, as mentioned is telling you, you aren't taking in enough fluids and electrolytes.
 

hollaatyaboyy1

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With those labs, Bun, glucose, sodium and potassium will determine how "hydrated" you were. They all can be "in range" it's the configuration of those values can determine if you're sufficiently hydrated.

If your albumin if heading towards 5 g/dL this is suggestive of insufficient hydration. 5 g/dL is "in range" although, as mentioned is telling you, you aren't taking in enough fluids and electrolytes.
D005AF64-5946-49EA-B189-B20EE93312C1.jpeg
 

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